1. Field of the Invention
The invention relates to the field of spinal restraints for treatment of humans, and particularly to spinal restraints adapted for emergency and rescue operations.
2. Description of the Prior Art
Spinal restraint boards, rescue boards, stretchers and the like are known in a variety of embodiments. The general function of such apparatus is to support an injured person during transport to a point of further processing. For example, victims of automobile accidents, soldiers injured in battle and victims of traumatic injury in general may be unable to transport themselves, at least without risk of further injury, and require a means of safe transportation to a place of medical treatment.
Victims or suspected victims of spinal injuries are especially vulnerable during transport. For example, a patient suffering from a broken neck or back may lack the necessary structural interconnection of vertebrae to limit displacement of body parts and to protect the spinal cord from traumatic injury during movement. Catastrophic traumatic injury can therefore occur to the spinal cord during transport, the patient possibly losing important body functions unnecessarily, becoming, for example, paraplegic or quadraplegic.
In order to deal with injuries to the cervical vertebrae and to deal with the danger of spinal cord injuries in general, the art has conceived of using relatively simple boards as stretchers, or in addition to stretchers, in order to maintain a predetermined relative position of a patient's body parts during transport. For injuries to cervical vertebrae, such restraint devices may be relatively short, for example, as shown in U.S. Pat. No. 4,127,120-Applegate or U.S. Pat. No. 4,034,748-Winner. These devices are adapted to engage and support the patient's torso and head, rather than to act as a complete stretcher. In U.S. Pat. No. 3,707,734-Matthews, a universal board is disclosed, operable as a full stretcher, or separable into parts for use as a torso board.
In each of the foregoing disclosures, the patient is held against the board by means of flat, relatively wide straps. Flat straps are comfortable in that they spread forces over a wider area, and may be made somewhat tighter than cylindrical or tubular laces, strings and ties. Most frequently, flat straps are adapted to pass perpendicularly across the torso or spinal board whereby they wrap smoothly over the sides of the board. In other words, the straps are attached near the edges of the board or wrapped around the edges of the board, and passed over the patient along a line perpendicular to an axis defined by the patient. In order to securely tighten the straps to hold the patient, such attachments must be length adjustable, for example, by means of a buckle or the like. Frequently, the straps resemble the usual garment-type belt having a buckle on one free end adapted to engage the other free end at one of a plurality of spaced holes.
A patient to be supported on a torso board or spine board is virtually always substantially smaller in width than the board. Accordingly, attachment of perpendicular straps at the edges of the board necessarily allows a certain amount of side-to-side movement of the patient even within the strap. Accordingly, such boards may be made narrow, frequently becoming progressively narrow towards the patient's feet and/or head. Another means of more closely restraining the patient is to run the straps diagonally over the patient, rather than perpendicularly with respect to the patient's axis. Straps running diagonally are necessarily more secure than straps running horizontally in that the straps exert an inward as well as a downward force on the patient with respect to the restraint board. Diagonal straps, however, are more complicated than perpendicular ones.
Examples of diagonal straps are shown in the aforesaid patent to Applegate, in which straps are looped around the patient and locked in holes in the board. In connection with narrow laces, string or rope, U.S. Pat. No. 3,151,343-McCormick also employs diagonal string lacing. In U.S. Pat. No. 4,283,068-Keyser, diagonal lacing is disclosed in connection with a resilient transport platform for game. U.S. Pat. No. 787,848-Lung teaches diagonal laces to close a blanket or bag over the victim.
In order to use a restraint system employing diagonal straps or laces according to the aforesaid patents, it is necessary to run the straps and/or laces through holes, hooks or like receptacles in the restraint board, the same being placed along the patient, for example, near the edges of the board. Alternatively, it is possible to use individual belts, which are connected over the patient using buckles. In any event, use of diagonal lacing requires either a plurality of relatively short inter-engageable lace or strap segments attached near the periphery of the board, or means for engaging intermediate portions of one or more long straps. In the event that long straps are employed, the user enjoys the benefit of fewer pieces, simpler storage and the like; however, lacing the ropes or straps through the holes in the torso board is quite slow. Moreover, lacing the straps through the board requires substantial free access to both the upper and lower surfaces of the board, necessitating either supporting the board well above the ground for attachment to the patient or repeatedly lifting the edges of the board, and possibly jarring the patient, in order to lace the patient down. Finally, the usual diagonal lacing as shown, for example, in McCormick, is not suitable for use with wide straps. Such straps will not lay flat unless they are passed diagonally from side to side across the board first above the patient, then across the board behind the patient, progressing helically around the patient and the board.
According to the present invention, diagonal straps are applied to a spinal board in a manner in which the straps are quickly and easily laced diagonally across the patient without the need to pass a strap under the patient or to otherwise jar the patient during the lacing procedure. Also according to the invention, the flat straps remain laying flat when routed through the progressive strap-engaging slots placed along the edges of the board.
The present invention also involves structure for applying the spine board to patients over a range of heights, including children and adults. The invention further involves a likewise universally applicable head restraint structure for protection of the cervical vertebrae. According to the invention, a pad in the general shape of an inverted "U" includes flaps at the ends of the inverted "U" legs, which flaps lay against the patient's shoulders when the head restraint is installed. The diagonal passage of flat straps attaching the patient to the restraint board further engage the head restraining mechanism, namely, at the shoulders, thereby restraining the head. The head restraint also includes means for engaging the board at or near the crown of the patient's head, and hook-and-pile fastened straps for engaging the patient's forehead and chin, the straps being attachable to the head restraint pad at a range of positions.
By virtue of the diagonal slots for attachment, the patient restraint system of the invention is very quickly installed and is at the same time very secure and comfortable. The generalized system also interacts with the head restraint, providing an optimum combination of convenience and effectiveness.